HAIR LOSS
It is normal to lose an average of 100 - 150 hairs per day. If there is more loss than this, it should be investigated. The most common cause of hair loss is the androgenetic type, which is commonly seen in men but also seen in women. Hair loss due to iron deficiency anemia is most common in women.
Apart from these,
- Hormone disorders (ovarian cysts - thyroid diseases)
- Extreme stress
- Severe fever illnesses after surgery
- Seasonal changes are also important factors in hair loss.
If there is a complaint of hair loss, the necessary blood tests are performed after the dermatologist examination. According to the result, treatment is given to correct the deficient values. If the tests come out clean, it is considered as androgenetic type loss. Shampoo and lotions are used to strengthen the hair. In addition, hair mesotherapy and PRP methods via injection into the scalp are applied.
Spot Treatment
Sunspots, called melasma in the medical terminology, are brownish formations on the face. It is more common in women than men. It is often bilateral and symmetrical in the facial region.
Sunbathing, pregnancy, thyroid diseases, hormone disorders, hormone treatments and birth control pills trigger sunspots. In the treatment of sunspots, spot creams, mesotherapy, PRP, microneedling antioxidant drugs, laser treatments and chemical peels can be used alone or in combination.
It is recommended for those with sunspot complaints to use sunscreen products with a factor of at least 30 every 4 hours, not to be exposed to too much sun even when using sunscreen, and to use wide-brimmed hats and glasses.
Acne (Pimple) Treatment
Acne is pimples on the face, back, and body caused by the activity of the sebaceous glands. It is seen in 2 separate periods, mainly adolescence acne and adult acne (after the age of 25). There are mild, moderate and severe types.
What Causes Acne?
The increased oil secretion during puberty accumulates in the hair structure and sebaceous glands, forming black and white spots called comedones.
Conditions such as application of oily creams, sweating, make-up, and not using appropriate cleaners clog the pores and the bacteria accumulated in the clogged pores lead to acne.
Is Acne Caused by Liver Disorder?
There is no relationship between acne and liver disorder.
Is There a Genetic Predisposition to Acne?
There is a genetic predisposition and it is more common in individuals with a family history of severe acne.
Is There a Relationship Between Diet and Acne?
No direct link has been found between acne and the foods we eat. Recently, however, it has been shown that foods that increase blood sugar rapidly cause insulin and some hormones to rise rapidly, thus triggering acne.
These foods include chocolate, potatoes, white bread, candy, fast food, deep-fried, instant juices, and crackers. Excessive intake of such foods is not recommended.
Is There a Connection Between Menstrual Irregularity and Acne?
If acne started after the age of 25, and if there are several of the complaints such as menstrual irregularity, weight gain, excessive hair growth around the chin, abdomen and nipples, an evaluation should be made in terms of hormone disorder and polycystic ovary disease.
Acne complaints may increase during menstrual periods, which is a natural process caused by hormones.
Is It Recommended to Pinch Acne?
Pinching and playing with acne is definitely not recommended. Inflammation may spread in pinched acne, increasing the risk of scarring. However, under the supervision of a doctor, comedones can be cleaned and abscesses can be drained.
Is There a Relationship Between the Sun and Acne?
Sun rays can alleviate acne. However, oil-free sunscreen products should be used and one should not be exposed to direct sunlight. Otherwise, stains may remain.
Can Acne Develop Even If It Is Not Treated?
Because recurring acne creates psychological stress, and can leave permanent scars, it must be treated by a dermatologist. The duration of treatment is determined according to the patient's condition.
Fungal Diseases
Fungi are the most common microorganisms in nature. They are often called as spores. Fungi stay in a dormant state. When there is a suitable environment, they wake up, become hyphae and cause disease. Suitable environments are high-temperature, humidity and wet environments. Although fungi are contagious, most fungal diseases in humans are caused by opportunistic fungi that come to life when this environment is formed. There are also fungal diseases that are directly transmitted from animals, but these form a small part. Infected fungi are transmitted from soil and animals. It causes fungal diseases on the scalp and body.
Opportunistic fungi, on the other hand, are fungi that develop due to sweat and humidity in the feet, groin and body (called sam yeli). If we pay attention to prevent the conditions such as sweating, staying in the heat and being in a humid environment, fungi will not develop on our body. For treatment, it is necessary to use antifungal pills and creams for a long time, and to continue the treatment even after a period of recovery.
Psoriasis - Vitiligo Diseases and Puva Therapy
VITILIGO
Vitiligo is a skin disease of unknown cause, in which white areas are seen due to loss of pigment in the skin. Any part of the body can be affected, most commonly the face, lips, hands, arms, legs and genitals. It occurs in 1% of the world's population and affects men, women and all races equally.
Who Contracts Vitiligo?
Vitiligo affects 1 or 2 people in 100 patients, it can be seen at any age from infancy to old age, but it starts before the age of 20 in half of the patients and 20% of the patients have a family history.
Is Vitiligo Internal Organ Disease? Is it contagious?
Vitiligo is not caused by any internal organ disease, so many patients are in good general health. Vitiligo is not contagious.
What are the Causes of Vitiligo?
The pigment called melanin determines skin, hair and eye color and is produced in cells called melanocytes. If these cells die or cannot produce melanin, the skin becomes lighter or completely white in color. It is unknown why this happens but there are 4 main theories,
- There may be a genetic abnormality causing damage to the melanocytes
- The body's immune system can break down the melanocytes, detect and destroy the pigment as a foreign body
- Abnormally functioning nerve cells can produce toxic substances that can damage melanocytes
- Pigment-producing cells can self-destruct. While making pigment, toxic products can be produced and can break down melanocytes
How Does Vitiligo Occur?
In vitiligo, the body makes and damages autoantibodies against its own melanocytes, the same auto-antibodies can cause damage to other organs such as the thyroid. Therefore, other autoimmune diseases may develop simultaneously with vitiligo.
Vitiligo can be triggered by sunburn. In people with light skin tone, the difference between vitiligo areas and normal skin becomes more pronounced in the summer, while vitiligo is more easily noticed in people with dark skin tone all year round.
Is Vitiligo A Disease That Can Be Treated?
Vitiligo is a treatable disease, but the exact cause of vitiligo is unknown, so the results of treatment may vary from person to person. There are different treatment options and these treatments should be applied for at least 3 months. The choice of treatment must be decided together with the dermatologist.
Do Herbal Products Have a Place in Vitiligo Treatment?
Do not apply any treatment (pill or cream) that is said to be herbal but not approved by the Ministry of Health, and consult your doctor.
PSORIASIS
Psoriasis is a disease that is common among people and continues for a long time with exacerbations. It is usually distinguished by sharply circumscribed redness with psoriasis (silver) colored dandruff (scaling) that gives the disease its name.
Is Psoriasis a Common Disease? At What Ages?
Psoriasis is common all over the world, genetic and environmental factors affect its frequency. The susceptibility to the disease can be passed on from the parents to the child, but the child may not have the disease. It occurs in one or 2 people out of every 100 people. It is equally common in men and women. It usually starts between the ages of 15 and 30.
What are the causes of the disease and the factors that lead to attacks?
The exact cause is not known, the immune system, genetic and environmental factors are thought to be effective. Environmental factors (throat infections due to streptococci, drugs [cortisone, lithium, some blood pressure medications, aspirin, etc.], excessive alcohol intake, smoking, scratching, scaling, sunburn, etc.) and mental stress may initiate or exacerbate the disease.
Is the Disease Contagious?
The disease is not transmitted to anyone by contact.
What are the Symptoms of the Disease?
Symptoms of the disease vary according to clinical particulars.
Psoriasis Vulgaris (Plaque Type Psoriasis)
It is the most common clinical psoriasis (80%). Typical symptoms are oval or round, raised skin rashes covered with silvery scales. It is frequently located on the knee, elbow, scalp and coccyx. Sometimes it can settle in folds such as armpits, groin, under the breasts, between the hips, behind the knees, inside the elbow and neck (Inverse Psoriasis). It can be seen on the palms and soles of the feet (Palmoplantar psoriasis)
Erythrodermic Psoriasis
The disease covers more than 90% of the body. The disease can become widespread under the influence of triggering factors such as drugs, sunlight, trauma and infection. Treatment should be carried out in the hospital.
Pustular Psoriasis
There are pus-filled pimples on a red background. It typically occurs on psoriasis plaques or on firm-looking skin. It can be common throughout the body (common pustular psoriasis) or localized to the palms and soles of the feet (palmoplantar pustular psoriasis).
Psoriasis of the Joints
It occurs in 2 out of 10 patients and in their 40s. Finger and waist joints are most commonly involved. It causes symptoms such as morning stiffness or stiffness that develops from sitting and standing for a long time, swelling of the fingers and toes ("sausage finger" appearance). Nail involvement is also common in joint involvement. It is often accompanied by skin manifestations of the disease.
Nail Changes in Psoriasis
Nails are affected in about half of the patients. Pinhead-sized pits on the nail surface, separation of the nail from its bed, yellowish discoloration under the nail (oil stain appearance), loss of a part of the nail, and thickening of the skin under the free part of the nail are common changes.
Allergy Diseases
Allergy tests are diagnostic tests applied to reveal the allergens that trigger complaints in allergic skin diseases. Since the reaction mechanisms that cause allergic diseases are different, the tests suitable for the disease are decided by your dermatologist.
The Most Commonly Used Allergy Tests in Dermatology:
- Patch Test
- Photo Patch, Atopy Patch Test
- Prick Test
- Intradermal Tests
- Autologous Serum Test
Patch Test
Patch test is a diagnostic test applied to detect allergens that may cause disease in patients diagnosed with allergic contact dermatitis (contact eczema).
Photo Patch Test
Some substances combine with sun rays and cause allergic dermatitis (photoallergic dermatitis). Photopatch test is a diagnostic approach applied to detect substances that may cause this disease.
Atopy Patch Test
The atopy patch test is performed to form an opinion on whether respiratory allergens (house dust mites, pollen, etc.) play a role in atopic dermatitis.
Drilling Test
The skin prick test is a test applied in cases whose complaints suggest the presence of a respiratory or food allergy. The test is applied directly to the respiratory tract and food allergens, latex or nutrients ("fresh pick").
Autologous Serum Skin Test
- The autologous serum skin test is intended to determine whether the patient's own serum will cause any reaction on the skin.
- The patient's blood is taken from the vein, his serum is separated, and then a very small amount (0.05 ml) of his own serum is injected into the skin, followed by evaluation after half an hour.
Intradermal Test
- Intradermal test is a diagnostic procedure applied to patients whose routine puncture test with respiratory tract allergens is negative, that is, no reaction is observed, but whose complaints suggest the presence of respiratory allergy.
- The method is based on the direct injection of respiratory tract allergens (house dust mite antigen, pollen antigens, etc.) diluted in certain concentrations into the skin with an injector.Callus - Wart Treatment
CALLUS TREATMENT
Calluses are skin thickenings that occur when the skin is exposed to friction and pressure. It mostly develops on the bony prominences of the feet and fingers and soles of the feet, causing pain and deformity. In the treatment, first of all, orthopedic problems that may cause callus, if any, should be eliminated. It is recommended to wear shoes with orthopedic soles suitable for the feet, and to use silicone pads to eliminate the pressure that will cause calluses. Callus melting creams can be used as medical treatment. Cryotherapy and curettage can be performed.
Wart Treatment
Warts are skin infections that develop due to the virus family called HPV. Slow-growing warts, which can remain for a long time without any complaints, are spread from person to person directly or through contact with surfaces and objects infected with the virus. Genital warts are the most common sexually transmitted diseases. It can also be transmitted from mother to baby during birth.
Warts can be treated with cryotherapy and electrocautery. Creams, pomades, gels and solutions containing various chemical agents can be used on warts. Depending on the immune status of the person, warts may recur.
Mole Examination and Follow-up (Dermatoscopy)
Moles are brown or black spots or bumps formed by color cells called melanocytes. Some are congenital and some may appear later. Sun rays can cause changes in existing moles, as well as cause new moles to appear. Since it has been shown that severe sunburn in childhood causes the development of many moles and increases the risk of skin cancer called melanoma, it is recommended to avoid the sun, especially at noon when the sun is high, to apply sunscreen with at least 30 SPF 20 minutes before going outdoors, and to use wide-brimmed hats and glasses.
The rapid growth of moles, its indented border, different colors, bleeding, development of tissue loss, whitening, itching, pain around it may be signs of worsening.
Nearly half of skin cancer called melanoma develops from moles. For this reason, moles should be examined at regular intervals, and suspicious moles should be removed and sent for pathological examination by looking at them with an instrument called dermatoscopy. There is no danger when moles are surgically removed.
Microneedling (Dermapen, Dermaroller)
Microneedling therapy is a procedure performed with a handheld device called a dermoroller or dermapen. It is an effective treatment method that can be easily applied in clinical conditions.
In this procedure, which is performed with instruments with needles made of stainless steel that can vary in length, micro-holes are opened in a controlled manner on the area to be treated with small needles. The skin perceives the microholes opened by the microneedles in the skin as a wound, and new connective tissue synthesis and new vessels begin to form with growth factors. In this way, a complete regeneration of the skin is initiated. In addition, the treatment success is increased by absorbing the treatment products selected according to the problem of the person through the microholes. This process can be used in facial rejuvenation, wrinkle and blemish treatment, pore tightening in those with large pores, treatment of acne and scars, hair loss and skin cracks.
Before the procedure, the application area is anesthetized with local anesthetic creams. After the skin is cleaned with antiseptic solutions, the application is started. The application time takes 15-20 minutes depending on the width of the application area. After the application, there is a rash that lasts for 2-3 days. Sun protection is recommended after treatment. It is recommended not to enter the bath, sauna, pool and sea on the day of the treatment and for a few days afterwards.
While a single session is sufficient for patients who only want a slight revival in their skin, it is recommended to apply at least 4 sessions at 1-2 week intervals in all other applications.
Punch, Excisional and Incisional Biopsy
When pathological examination is required to diagnose skin diseases, the procedure in which the entire lesion is removed according to the size of the lesion is excisional biopsy, and the procedure that allows partial sampling from the lesion is incisional biopsy. Punch biopsy is the process of taking tissue samples from the lesioned skin with instruments in the form of a full-thickness cylinder with millimeter-sized tips of different diameters. During the procedure, after the area to be biopsied is cleaned with an antiseptic solution, regional anesthesia is performed and biopsy is performed with appropriate instruments. After the biopsy is taken, the wound is closed by suturing. Stitches are removed after an average of one week. In very small lesions, the wound closes spontaneously with secondary healing without suturing.
Phototherapy
It is a treatment method in which certain wavelengths of sun light (ultraviolet) are used in the treatment of many skin diseases, mainly psoriasis, vitiligo, eczema, chronic itching, alopecia areata, which is called ringworm among people, and skin lymphomas. Treatment using only light is called phototherapy, and treatment with photosensitizing drugs is called photochemotherapy. PUVA therapy, on the other hand, is a photochemotherapy method in which photosensitizing psoralen (P) and ultraviolet A (UVA) rays are used together. Artificial sunlight is used in phototherapy, and it is a treatment method that is completely different from radiotherapy, which is called radiation therapy among the people.
Ultraviolet lights destroy the inflammation in the skin and ensure the improvement of the disease and the absence of new lesions. Treatment sessions begin with a few seconds of light exposure in a closed cabin with ultraviolet lamps that emit artificial sunlight for 2-4 sessions per week, and the durations are gradually increased. When the response to the treatment is received, the sessions are gradually reduced and stopped. During the treatment sessions, the genital area in men and the nipples in women should be covered, risky moles and scars should be covered with a plaster, and the eyes should be protected with special glasses or eye patches.
Long-term and uncontrolled exposure to the sun and sunburn cause skin aging, cataracts and skin cancer, but phototherapy performed under the control of a physician is a safe and effective method. During treatment, skin dryness, redness, and tanning may occur.
Electrocautery
Electrocautery, which is also known as burning treatment among the people, is a treatment method that is effective through cutting and coagulation by using electrical energy and creating heat damage to the tissue with appropriate devices. Damaged and diseased tissue is destroyed by burning, and healing of the diseased and damaged tissue is ensured along with wound healing. Local anesthesia is applied to avoid pain before the procedure. After the procedure, it is recommended to keep the application area dry and to use the creams provided.
It is used in the treatment of lesions such as flesh mole (acrochordon), wart, milium (fat cyst), pyogenic granuloma, seborrheic keratosis, syringoma, sebaceous hyperplasia, xanthelasma, telangiectasia, cherry angioma, angiokeratoma.
Ingrown Toenails and Treatment
Ingrown nail is the ingrowth of the nail into the soft tissue. This condition usually occurs in the big toe and is a painful condition that causes significant loss of activity. Ingrown toenails, faulty and deep nail cutting, abnormally shaped nails and nail folds, excessive sweating, wearing narrow shoes, poor foot hygiene, excessive body weight, pregnancy, use of drugs such as retinoic acid, genetic factors, exposure of the feet to continuous impact and trauma, It is due to several factors, such as fungal infection of the nail, or a combination of these. Ingrown toenails are rarely seen in communities that do not wear shoes.
Pain, swelling and redness are seen around the ingrown nail. In advanced nail ingrowns, the inflammation of the wound and the reaction of the soft tissue cause the tissue around the nail to swell and a bleeding tissue rich in vessels is formed.
In ingrown toenails, the treatment varies according to the degree and shape of the ingrown. Lotions and creams can be used to soften and regress the fluffy tissue on the edge of the nail. Surrounding tissue can be burned with silver nitrate pens. The nail wire, which prevents the nail from ingrowing and remains on the nail until the nail grows and the ingrown passes, can be applied. Sometimes, part or all of the nail may need to be removed. In much inverted nails, the root part of the nail is produced by burning with chemicals such as phenol or with tools such as cautery, laser, and regrowth of the nail in the ingrown parts can be prevented. Nail removal is a painless procedure performed under local anesthesia. After removal, you can easily return home on foot.
To avoid recurrence of ingrown nails, the nail should be cut straight and the corners of the nails should be seen outside. Flat and soft-textured shoes should be used so that the front part takes the shape of the foot, and the feet should be protected from traumas and impacts. If there is accompanying excessive sweating and fungal infections, it should be treated.
Cryotherapy
Cryotherapy, also known as freezing treatment among the people, is a treatment method that is effective by using various cryogens with appropriate equipment and creating cold damage to the tissue. In dermatology, treatment is most often performed with a tube containing liquid nitrogen at -196 degrees. In cold application, first an ice ball is formed, then melting occurs in the application area. Depending on cold damage, pain, swelling and fluid collection develop in the application area after the application. Along with wound healing, the healing of diseased and damaged tissue is ensured. Local anesthesia is usually not needed as it is not as painful as other methods.
It is used in the treatment of warts, calluses, molluscum contagiosum, sunspots, seborrheic keratosis, actinic keratosis, actinic cheilitis, basal cell skin cancer, Kaposi's sarcoma, prurigo nodularis, keloid, dermatofibroma.
It should not be applied to patients with diseases such as cold urticaria, cold intolerance, cryoglobulinemia, cryofibrinogenemia and arteriosclerosis in the lower extremities.
